Thawing Human Milk for Hospitalized Infants: Use of a Laboratory Bead Bath May Be an Effective Method for Large Quantities

Abstract

Human milk for hospitalized infants in the neonatal intensive care unit (NICU) is often stored frozen and must be thawed before use. Frozen milk must be properly thawed, ensuring that no ice crystals remain, while minimizing overheating, to reduce risk of microbial growth and prevent nutrient loss. 1 Robbins S.T. Meyers R. Infant Feedings: Guidelines for Preparation of Human Milk and Formula in Health Care Facilities. 2nd ed. American Dietetic Association, Chicago, IL2011 Google Scholar , 2 Jones F. Best Practice for Expressing, Storing and Handling Human Milk in Hospitals, Homes, and Child Care Settings. 3rd ed. Human Milk Banking Association of North America, Fort Worth, TX2011 Google Scholar Although frozen milk may be thawed in the refrigerator over 8 to 12 hours, such a process may not be as effective for thawing large volumes for multiple patients or may result in human milk waste if orders change frequently. Therefore, some facilities may require a more rapid thawing method. 1 Robbins S.T. Meyers R. Infant Feedings: Guidelines for Preparation of Human Milk and Formula in Health Care Facilities. 2nd ed. American Dietetic Association, Chicago, IL2011 Google Scholar Such methods include holding the bottle under lukewarm running water or placing it in a container of warm water with the water level below the lid to prevent contamination. 1 Robbins S.T. Meyers R. Infant Feedings: Guidelines for Preparation of Human Milk and Formula in Health Care Facilities. 2nd ed. American Dietetic Association, Chicago, IL2011 Google Scholar However, research has shown that hospital tap water is one potential source of pathogenic organisms in the patient care environment and can cause nosocomial infections. 3 Cervia J.S. Ortolano G.A. Canonica F.P. Hospital tap water: A reservoir of risk for health care-associated infection. Infect Dis Clin Pract. 2008; 16: 349-353 Crossref Scopus (24) Google Scholar , 4 Anaissie E.J. Penzak S.R. Dignani M.C. The hospital water supply as a source of nosocomial infections: A plea for action. Arch Intern Med. 2002; 162: 1483-1492 Crossref PubMed Scopus (297) Google Scholar Commercial bottle warmers that use tap water also have been reportedly linked with Pseudomonas aeruginosa infections in one NICU. 5 Molina-Cabrillana J. Artiles-Campelo F. Dorta-Hung E. et al. Outbreak of Pseudomonas aeruginosa infections in a neonatal care unit associated with feeding bottles heaters. Am J Infect Cont. 2013; 41: e7-e9 Abstract Full Text Full Text PDF PubMed Scopus (7) Google Scholar Such data have consequently led some experts to recommend that hospitalized patients at high risk for infection avoid all exposure to hospital tap water. 4 Anaissie E.J. Penzak S.R. Dignani M.C. The hospital water supply as a source of nosocomial infections: A plea for action. Arch Intern Med. 2002; 162: 1483-1492 Crossref PubMed Scopus (297) Google Scholar